Apr 29, 2026
A visit to the hospital in America can turn into a major financial burden fast.
Research from the National Library of Medicine (1) in 2024 found that 36% of U.S. households had medical debt, 21% had a past-due medical bill and 23% were paying a medical bill over time to a provider.
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With that in mind, it’s no surprise people make changes to their lives to accommodate these costs. A recent survey from West Health-Gallup Center on Healthcare in America (2) found that 62% of people without insurance and 29% of those with coverage made one or more trade-offs in their spending and lifestyle to pay for health expenses.
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When Sarah’s coworker took a trip to the emergency room after a painful bike accident and saw the resulting $3,100 hospital bill, she panicked. Rent was due soon and her credit card was nearly maxed out. Adding such a large bill felt impossible.
Thankfully, she called the hospital’s billing department and was able to get the bill reduced to $280, even with insurance.
Accidents can happen to anyone, which left Sarah wondering: if I were in my coworker’s situation, could I do the same?
Call the hospital billing department to get started
While Sarah and her coworker are fictional, situations like this affect real Americans. Knowing how to handle them can be a lifesaver.
Over the previous five years, “the average premium for family coverage has increased by 26%, compared with a 29% increase in workers’ wages and nearly 24% growth in inflation,” according to KFF Health News (3). Even with insurance, many people are looking for ways to lower their medical bills.
Every situation is different, but a good first step is to call the hospital’s billing department to understand your options. Here are some common ways to reduce your bill.
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Financial assistance programs
Not all hospitals offer financial assistance, but it’s worth asking. Often called “charity care,” these programs offer financial aid to lower-income patients who need help paying medical bills.
According to the Consumer Financial Protection Bureau (CFPB) (4), nonprofit hospitals must meet a community benefit standard to maintain their nonprofit status. Part of that includes providing financial assistance to patients who cannot pay.
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Eligibility varies by state and typically uses the federal poverty level as a guide. For example, the Washington State Department of Health (5) requires hospitals to provide free care to patients with family incomes below 100% of the federal poverty level (FPL) and discounted care to those earning up to 200%.
Negotiating with a hospital
If you aren’t eligible for charity care, you can still try to negotiate your bill.
The Community Health Advocates (6) program at the Community Service Society of New York suggests taking the following steps:
- Look up the fair market price for the service so you can compare it with what you were charged.
- Explain your financial situation and ask for a discount. You may need to write a financial hardship letter and include documents like pay stubs, credit card statements and proof of other debts.
- Tell the billing department what you can afford and how you can pay. Work together on a payment plan.
- Consider offering a lump sum in exchange for a lower total.
Ask your insurance company to reconsider
If those options don’t work out, you can contact your insurance company and have them go over the bill with you. Ask for clarification on any charges and make sure your coverage was applied correctly.
You can also ask your insurer for a prompt-pay discount, which applies when you pay around the time of service. That can be harder to arrange in an emergency, but it’s still worth asking.
Article Sources
We rely only on vetted sources and credible third-party reporting. For details, see our editorial ethics and guidelines.
National Library of Medicine [(1)](https://pmc.ncbi.nlm.nih.gov/articles/PMC12394938/#:~:text=Overall%2C%2036%25%20(SE%2C,were%20removed%20in%20our%20analysis.); West Health-Gallup (2); KFF Health News (3); Consumer Financial Protection Bureau (4); Washington State Department of Health (5); Community Health Advocates (6)
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Em Norton is a Content Specialist at moneywise.com. They have been with the company since 2022.
